Health Insurance Exchange Arizona Consumer Guide

Arizona's health insurance exchange, also known as the Health Insurance Marketplace, is a platform where individuals and families can shop for and enroll in health insurance plans. It's a great resource for those who need coverage but can't get it through their employer.

The exchange is open to residents of Arizona who don't have access to employer-sponsored health insurance or who are self-employed. To be eligible, you must be a U.S. citizen or lawfully present immigrant.

You can enroll in a plan through the exchange during the annual open enrollment period, which usually runs from November to December, or during a special enrollment period if you experience a qualifying life event, such as losing your job or getting married.

For more insights, see: Dental Insurance Nebraska No Waiting Period

Arizona's health insurance landscape is changing, and it's essential to stay informed. Eight private insurance companies will offer coverage through Arizona's health insurance Marketplace for 2025.

Medica is leaving the Arizona market at the end of 2024, which means consumers will have fewer options for 2025. However, Antidote Health Plan is new for 2025, providing an alternative for those seeking coverage.

If this caught your attention, see: Will Insurance Cover Wegovy for High Cholesterol

One carrier offered coverage statewide in 2024, but that's not the case for 2025. Plans will be available from multiple insurers in varying coverage areas throughout the state.

Consumers should research their options carefully to find the best fit for their needs. With eight insurers offering coverage in 2025, there are plenty of choices to consider.

In some areas of the state, plans were only available from one insurer in 2024. This limited competition can drive up costs and reduce choices for consumers.

Recommended read: Health Insurance Companies in Massachusetts

Enrolling in a health insurance plan through the Arizona health insurance marketplace is a straightforward process. You can start by comparing available plans through the Arizona health insurance marketplace.

You can enroll in a Marketplace plan in Arizona directly through HealthCare.gov, by phone at (800) 318-2596, or with the help of a local agent/broker, Navigator, or certified application counselor.

The enrollment process involves assessing your needs and budget, and completing an application which may require details about your income and household size to determine your eligibility for subsidies or Medicaid. You can also seek help from certified brokers or agents who are trained to navigate the enrollment process.

Related reading: Can I Add Dental Insurance Later

You can enroll in individual or family health plans during the Open Enrollment Period (OEP) in Arizona, which typically runs from November 1 to December 15 each year. If you experience major life changes like marriage, relocation, or loss of health coverage outside this period, you may qualify for a Special Enrollment Period.

Here are the main ways to enroll in a Marketplace health plan in Arizona:

You can also use online insurance marketplaces like eHealth to explore a wide range of health insurance plans, compare coverage options, and easily enroll in a plan that suits your needs during the OEP.

In Arizona, you have several options for enrolling in a Marketplace plan. You can enroll directly through HealthCare.gov, or by phone at (800) 318-2596 (TTY: 1-855-889-4325).

There are four main categories of health insurance plans, known as metal tiers: Bronze, Silver, Gold, and Platinum. These tiers help you understand how costs are split.

Bronze plans have the lowest monthly premiums but you pay more when you see a doctor. Silver and Gold plans require higher premiums, but your out-of-pocket costs are lower when you get care. Platinum plans charge the highest premiums but cover the most when you need medical treatment.

You can choose from several insurers offering individual and family health insurance in Arizona, including Arizona Complete Health, Banner Health and Aetna Health Plan Inc., Blue Cross Blue Shield of AZ, and UnitedHealthcare of Arizona, Inc.

Here are some specific insurers and the areas they serve:

All Marketplace plans cover essential health benefits, including prescription drug coverage, pregnancy and newborn care, pediatric services, mental health, lab tests, ER and hospital services, and preventive and wellness services.

Affordable health insurance is within reach in Arizona, with options like the HealthCare.gov Marketplace, which offers income-based subsidies to lower monthly premiums. About 90% of Marketplace enrollees in Arizona qualified for premium subsidies in 2024, saving on average $453 monthly.

Explore further: Monthly Premium for Health Insurance

You can also consider short-term health insurance if you need a more budget-friendly option and are ineligible for Marketplace subsidies or Medicaid. Short-term plans can be applied for at any time, but you may be declined based on medical questions.

Here are the average marketplace premiums by "metal" tier in 2024, according to the Kaiser Family Foundation:

Cost-sharing reductions can also lower out-of-pocket costs for medical care, available for individuals and families who select a Silver plan.

You can find affordable health insurance in Arizona by shopping on HealthCare.gov, the state's health insurance Marketplace. This is where you can explore income-based subsidies that can help lower your monthly premiums.

About 90% of Marketplace enrollees in Arizona qualified for premium subsidies in 2024, saving an average of $453 monthly. With subsidies, enrollees paid an average of $115 per month for health coverage.

To qualify for these subsidies, your household income must be below a certain threshold. The exact amount varies depending on your family size and the number of people in your household.

Suggestion: Average Group Health Insurance Premium

If you're eligible for Medicaid, you can enroll through the Arizona Health Care Cost Containment System (azahcccs.gov) or Health-e-Arizona (healthearizonaplus.gov). This can be a more affordable option, especially if you have a low income.

You can also consider short-term health insurance if you need a more budget-friendly option and are either ineligible for Marketplace subsidies or Medicaid, or missed the enrollment window for a Marketplace plan.

Here are some key features to consider when evaluating health insurance plans in Arizona:

These prices are based on data from the Kaiser Family Foundation and may vary depending on your location and other factors.

It's essential to assess your personal needs and research available options in your area before making a decision. You can start by visiting eHealth.com to compare Obamacare plans, short-term plans, and other alternatives.

Are premiums increasing? Let's take a look at the facts. In Arizona's individual/family insurance market, some issuers are increasing their average rates for 2025, while others are decreasing theirs.

Aetna CVS Health/Banner Health, for example, is increasing its rates by 10.35%. Cigna HealthCare of AZ, Inc. is increasing its rates by 3.92%. On the other hand, Arizona Complete Health (Health Net of AZ) is decreasing its rates by 6.1%.

Here's a breakdown of the average rate changes for 2025, applicable to full-price plans:

It's worth noting that these rates are for full-price plans, and most Arizona Health Insurance Marketplace enrollees receive premium subsidies, so their net rate change also depends on how much their subsidy changes.

To enroll in health insurance in Arizona, you must go through the Open Enrollment Period, which typically runs from November 1 to December 15 each year. If you experience major life changes, you may qualify for a Special Enrollment Period.

You can enroll in Arizona Obamacare plans through the Arizona health insurance marketplace or by contacting the Marketplace's call center for assistance. You can also seek help from certified brokers or agents.

The enrollment process involves comparing available plans, assessing your needs and budget, and completing an application that may require details about your income and household size to determine your eligibility for subsidies or Medicaid.

In Arizona, Medicare enrollment is a crucial step in securing your healthcare coverage.

You'll usually become eligible for Medicare when you turn 65, although some may qualify earlier due to certain disabilities or medical conditions.

It's essential to enroll in Medicare during the Initial Enrollment Period (IEP) to avoid late enrollment penalties.

Medicare beneficiaries in Arizona have access to a wide range of healthcare providers, including hospitals, doctors, specialists, and pharmacies.

Many may also choose to enhance their Medicare coverage through Medicare Advantage plans, which can offer additional benefits and services beyond Original Medicare.

Understanding the enrollment process is crucial for beneficiaries to make informed decisions about their healthcare coverage in Arizona.

To be eligible to buy health insurance through the Arizona Health Insurance Marketplace, you must live in Arizona. You also need to be lawfully present in the U.S. and not be incarcerated.

You can't be enrolled in Medicare, which is a different type of health insurance program. To qualify for financial assistance, you can't be eligible for affordable coverage offered by an employer. This means you need to check if the employer-sponsored coverage available to you is considered affordable.

Expand your knowledge: Do I Need Us Health Insurance If I Live Abroad

To get financial assistance, you also can't be eligible for AHCCCS (Medicaid) or KidsCare (CHIP). Additionally, you can't be eligible for premium-free Medicare Part A. If you're married, you need to file a joint tax return. You also can't be claimed by someone else as a tax dependent.

Here are the basic eligibility requirements in a nutshell:

And to qualify for financial assistance:

You can enroll in an ACA-compliant plan in Arizona during the open enrollment period, which runs from November 1 to January 15.

There are a few exceptions to this rule: if you're eligible for premium tax credits and your income is not more than 150% of the poverty level, you can enroll anytime; if you're part of the American Indian/Alaska Native population, you can enroll whenever necessary.

If you lose AHCCCS or KidsCare (Medicaid/CHIP) coverage between March 31, 2023 and November 30, 2024, you can enroll through the extended SEP.

A unique perspective: Re Organize Health Insurance in America

To start your enrollment process, you'll need to act by December 15 if you want your coverage to begin on January 1. If you sign up between December 16 and January 15, your coverage will start on February 1.

Here are the specific enrollment deadlines to keep in mind:

Keep in mind that you may still be able to sign up for or make changes to an ACA Marketplace health plan through a special enrollment period (SEP) if you experience a qualifying life event.

Health insurance plans in Arizona can be categorized into four metal tiers: Bronze, Silver, Gold, and Platinum. These tiers help you understand how costs are split, with Bronze plans having the lowest monthly premiums but higher out-of-pocket costs when seeing a doctor.

UnitedHealthcare offers individual and family health insurance plans in Arizona, including ACA Marketplace plans with affordable coverage options. You can call 1-800-273-8095 to talk to a licensed insurance agent.

Marketplace plans cover 10 essential health benefits, including prescription drug coverage, pregnancy and newborn care, and mental health services. Plans also fully cover preventive and wellness services, so you won't have any out-of-pocket costs for these benefits.

Here's a comparison of some insurance types available on eHealth.com:

If you're looking for dental coverage in Arizona, you're in luck because there are options available. Dental insurance can be a smart addition to your health coverage, and it may be worth exploring.

Arizona Health Matters is a resource that provides information about health concerns in Arizona, including dental care.

You can also check out guides that explore dental coverage options in Arizona, which can help you make an informed decision.

You can enroll in a Marketplace plan in Arizona through various methods, including directly through HealthCare.gov, by phone, or with the help of a local agent/broker.

There are four main categories of health insurance plans in Arizona: Bronze, Silver, Gold, and Platinum. These metal tiers help you understand how costs are split, with Bronze plans having the lowest monthly premiums but higher out-of-pocket costs.

In the 2024 plan year, eight private insurance companies will offer coverage through Arizona's health insurance Marketplace, with varying coverage areas. You can choose a plan that suits your needs and budget.

UnitedHealthcare Individual & Family ACA Marketplace plans are available in Arizona, offering affordable and reliable coverage options. You can call 1-800-273-8095 to talk to a licensed insurance agent.

Short-term health plans provide temporary health insurance for consumers who may find themselves without comprehensive coverage. However, these plans have limitations and may not offer the same level of coverage as Marketplace plans.

You can expect to have 10 essential health benefits, including prescription drug coverage, pregnancy and newborn care, and mental health services, with your Marketplace plan.

Here's a breakdown of the essential health benefits covered by Marketplace plans:

Remember to consider your budget and needs when selecting a plan, as premiums and out-of-pocket costs vary depending on the metal level of your plan.